The Korean National Liver Cancer Surveillance Program: Experience of a Single Healthcare Center in 2011 / 대한내과학회지

ABSTRACT

BACKGROUND/AIMS: The aim of this study was to investigate outcomes and current status of the National Liver Cancer Screening Program in a single healthcare center. METHODS: Subjects received abdominal ultrasonography (US) and/or serum alpha-fetoprotein (AFP) testing from January 2011 to December 2012. The clinical characteristics of the subjects, detection rate of liver cancer, and direct medical costs were investigated. RESULTS: Among 621 subjects, five (0.8%) were newly detected with hepatocellular carcinoma. Four underwent curative treatment, and all were detected by US (two surgical resections and two radiofrequency ablations). The remaining patient, whose disease was detected by an elevated AFP level, was infiltrative type with a poor prognosis. Of 492 subjects whose medical history was revealed, 45% had hepatitis B, 5% had hepatitis C, 1% had both, and 3% had other liver cirrhosis including alcoholic cirrhosis. The remaining 46% of subjects had no risk factors for liver cancer. Direct medical costs were estimated at 8,420,000 Won for detecting a single case of liver cancer, which was much lower than that of stomach cancer at 45,060,000 Won. If the non-high risk subjects were excluded, the cost for a single case of liver cancer decreased to 5,560,000 Won. CONCLUSIONS: The high-risk group should be more accurately defined by appropriate screening tests to optimize liver cancer surveillance. The detection rate by the liver cancer surveillance program was about 1%, and most tumors could be detected at the early stage by US. The role of AFP seemed to be small for early defection of liver cancer.